Free Chapter 2

Holland/Adams/Brice, Core Concepts in Pharmacology 4th Edition Test Bank
Chapter 2

Question 1

Type: MCSA

A student nurse asks what the difference between a therapeutic class and a pharmacologic class is. What is the best response by the nurse educator?

Therapeutic classification is how the medication produces an effect in the body, whereas pharmacologic classification is how a medication works clinically.

Therapeutic classification is how addictive a medication is, whereas pharmacologic classification is how the medication produces an effect in the body.

There are no differences between therapeutic and pharmacologic classes.

Pharmacologic classification is how the medication produces an effect in the body, whereas therapeutic classification is how a medication works clinically.

Correct Answer: 4

Rationale 1: Therapeutic classification is how the medication produces an effect in the body, where as pharmacologic classification is how a medication works clinically is incorrect because pharmacologic classification is how the medication produces an effect in the body, while therapeutic classification is how a medication works clinically.

Rationale 2: Therapeutic classification is how addictive a medication is, where pharmacologic classification is how the medication produces an effect in the body is incorrect because pharmacologic classification is how the medication produces an effect in the body, while therapeutic classification is how a medication works clinically.

Rationale 3: There are no differences between therapeutic and pharmacologic classes is incorrect because pharmacologic classification is how the medication produces an effect in the body and therapeutic classification is how a medication works clinically.

Rationale 4: Pharmacologic classification is how the medication produces an effect in the body, whereas therapeutic classification is how a medication works clinically.

Global Rationale: Pharmacologic classification is how the medication produces an effect in the body, where therapeutic classification is how a medication works clinically. Therapeutic classification is how the medication produces an effect in the body, where pharmacologic classification is how a medication works clinically is incorrect because pharmacologic classification is how the medication produces an effect in the body, while therapeutic classification is how a medication works clinically. Therapeutic classification is how addictive a medication is, where pharmacologic classification is how the medication produces an effect in the body is incorrect because pharmacologic classification is how the medication produces an effect in the body, while therapeutic classification is how a medication works clinically. There are no differences between therapeutic and pharmacologic classes is incorrect because pharmacologic classification is how the medication produces an effect in the body and therapeutic classification is how a medication works clinically.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-1 Discuss the basis for placing drugs into therapeutic and pharmacologic classes.

Question 2

Type: MCSA

The nurse is preparing to administer a drug that is labeled “used for minor skin irritations.” Based on the label, how is this drug classified?

By the function

By its usefulness

By its pharmacologic use

By its therapeutic use

Correct Answer: 4

Rationale 1: Function is not a classification for medications.

Rationale 2: Usefulness is not a classification for medications.

Rationale 3: Pharmacological classification categorizes drugs by how they work pharmacologically.

Rationale 4: When organized by therapeutic classification, a statement is made about what a particular drug does clinically.

Global Rationale: When organized by therapeutic classification, a statement is made about what a particular drug does clinically. Pharmacological classification categorizes drugs by how they work pharmacologically. Function and usefulness are not classifications for medications.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2-1 Discuss the basis for placing drugs into therapeutic and pharmacologic classes.

Question 3

Type: MCSA

A nursing instructor is teaching fundamental pharmacological content. In helping the students become comfortable with this material, what should the instructor suggest that the student focus on initially?

The prototype

The generic names

The trade names

The adverse effects

Correct Answer: 1

Rationale 1: The prototype drug is the original, well-understood drug model from which other medications in a pharmacological class have been developed. It is recommended that students first become comfortable with the broad drug classes and then gradually move to more specific examples, and the prototype drugs are excellent places to start.

Rationale 2: Generic versus trade names is considered specific examples in a broader classification.

Rationale 3: Generic versus trade names is considered specific examples in a broader classification.

Rationale 4: Learning about adverse effects of medications is important, but it is not a beginning step to understanding fundamental pharmacological content.

Global Rationale: The prototype drug is the original, well-understood drug model from which other medications in a pharmacological class have been developed. It is recommended that students first become comfortable with the broad drug classes and then gradually move to more specific examples, and the prototype drugs are excellent places to start. Generic versus trade names is considered specific examples in a broader classification. Learning about adverse effects of medications is important, but it is not a beginning step to understanding fundamental pharmacological content.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-2 Explain the prototype approach to drug classification

Question 4

Type: MCSA

What is the original, well-understood drug model from which other medications in a pharmacologic class have been developed?

A proprietary drug

A combination drug

A generic drug

The prototype drug

Correct Answer: 4

Rationale 1: A proprietary drug name is the trade name of a medication.

Rationale 2: A combination drug is one that contains more than one active ingredient.

Rationale 3: A generic drug name is a name that is assigned by the U.S. Adopted Name Council.

Rationale 4: A prototype drug is the original, well-understood drug model from which other medications in a pharmacologic class have been developed.

Global Rationale: A prototype drug is the original, well-understood drug model from which other medications in a pharmacologic class have been developed. A proprietary drug name is the trade name of a medication. A combination drug is one that contains more than one active ingredient. A generic drug name is a name is assigned by the U.S. Adopted Name Council.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process:

Learning Outcome: 2-2 Explain the prototype approach to drug classification

Question 5

Type: MCMA

Which statements regarding prototype drugs are not accurate? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A nurse can apply understanding of the effects of a prototype drug to other drugs in the same class.

Understanding the effects of the prototype drug does not help the nurse to understand the effects of other drugs in the same class.

The mechanism of action is different for the prototype drug than for other drugs in the same class.

The most commonly used drug in a specific class is always the most widely prescribed drug.

Prototype drugs rarely cause drug resistance.

Correct Answer: 2, 3, 4

Rationale 1: After learning the prototype drug, students can predict the actions and adverse effects of other drugs in the same class.

Rationale 2: After learning the prototype drug, students can predict the actions and adverse effects of other drugs in the same class.

Rationale 3: The prototype drug is the original, well-understood drug model from which other medications in a pharmacologic class have been developed.

Rationale 4: In many cases, the original drug prototype is not the most widely used drug in its class.

Rationale 6: As new drugs are developed, features such as antibiotic resistance, fewer side effects, or a more precise site of action might be factors that sway healthcare providers away from using the older prototype drugs.

Global Rationale: After learning the prototype drug, students can predict the actions and adverse effects of other drugs in the same class. The prototype drug is the original, well-understood drug model from which other medications in a pharmacologic class have been developed. In many cases, the original drug prototype is not the most widely used drug in its class. After learning the prototype drug, students can predict the actions and adverse effects of other drugs in the same class. As new drugs are developed, features such as antibiotic resistance, fewer side effects, or a more precise site of action might be factors that sway healthcare providers away from using the older prototype drugs.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-2 Explain the prototype approach to drug classification

Question 6

Type: MCSA

A generic drug takes 60 minutes to produce a therapeutic effect; the brand name drug takes the same amount of time to produce the same effect. This phenomenon is an example of which pharmacological concept?

Bioavailability

Efficacy

Therapeutic effect

Adverse effect

Correct Answer: 1

Rationale 1: Bioavailability is the physiologic ability of the drug to reach its target cells and produce its effect.

Rationale 2: Efficacy is the ability of a drug to produce an effect.

Rationale 3: Therapeutic effect is the anticipated, hoped-for effect of the drug.

Rationale 4: An adverse effect is an undesirable response of the drug (e.g., vomiting).

Global Rationale: Bioavailability is the physiologic ability of the drug to reach its target cells and produce its effect. Efficacy is the ability of a drug to produce an effect. Therapeutic effect is the anticipated, hoped-for effect of the drug. An adverse effect is an undesirable response of the drug (e.g., vomiting).

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2-3 Describe what is meant by a drug’s mechanism of action.

Question 7

Type: MCSA

The physiologic ability of the drug to reach its target cells and produce its effect is known as which pharmacological concept?

Efficacy

Bioavailability

Therapeutic effect

Adverse effect

Correct Answer: 2

Rationale 1: Efficacy is incorrect because efficacy is the ability of a drug to produce an effect.

Rationale 2: Bioavailability is the physiologic ability of the drug to reach its target cells and produce its effect.

Rationale 3: Therapeutic effect is incorrect because therapeutic effect is the anticipated, hoped-for effect of the drug.

Rationale 4: Adverse effect is incorrect because an adverse effect is an undesirable response of the drug (e.g., vomiting).

Global Rationale: Bioavailability is the physiologic ability of the drug to reach its target cells and produce its effect. Efficacy is incorrect because efficacy is the ability of a drug to produce an effect. Therapeutic effect is incorrect because therapeutic effect is the anticipated, hoped-for effect of the drug. Adverse effect is incorrect because an adverse effect is an undesirable response of the drug (e.g., vomiting).

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2-3 Describe what is meant by a drug’s mechanism of action.

Question 8

Type: MCMA

Which drug names are examples of trade names? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Calcium channel blocker

Benadryl

Loop diuretic

Acetaminophen

Motrin

Correct Answer: 2, 5

Rationale 1: Calcium channel blocker is a pharmacologic classification, not a trade name.

Rationale 2: Benadryl is the trade name for diphenhydramine.

Rationale 3: Loop diuretic is a pharmacologic classification, not a trade name.

Rationale 4: Acetaminophen is a generic name. A trade name for this medication is Tylenol.

Rationale 5: Motrin is a trade name for ibuprofen.

Global Rationale: Benadryl is the trade name for diphenhydramine. Motrin is a trade name for ibuprofen. Calcium channel blocker is a pharmacologic classification, not a trade name. Loop diuretic is a pharmacologic classification, not a trade name. Acetaminophen is a generic name.  A trade name for this medication is Tylenol.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2-4 Distinguish between a drug’s chemical name, generic name, and trade name.

Question 9

Type: MCSA

A nurse is discussing generic and trade drugs with a client. The client wants to know why it takes so long for trade drugs to become available in the generic form, which are generally cheaper. What is the nurse’s best response?

It takes 17 years for all pharmaceutical companies to develop a generic version of the drug.

It will take 17 years of clinical trials to approve the drug.

Sole ownership of a drug allows the pharmaceutical company to earn back the money spent to develop the drug.

Animal testing must continue for 10 years, then 7 years of human clinical trials, for a drug to be approved.

Correct Answer: 3

Rationale 1: The generic version of the drug is already developed but the copyright of the drug is owned by the pharmaceutical company that developed it for 17 years.

Rationale 2: The length of time for a drug to be approved by the FDA varies.

Rationale 3: Sole ownership of a drug allows the pharmaceutical company to earn back the money spent to develop the drug. For example, if it takes 7 years for a drug to be approved, competing companies will not be allowed to market a generic equivalent drug for another 10 years. The rationale for this is that the developing company must be allowed sufficient time to recoup the millions of dollars spent in research needed to develop the new drug. After 17 years, competing companies may sell a generic equivalent drug-using: a different name, which the FDA must approve.

Rationale 4: A drug can be approved in a much shorter period of time, and animal testing does not last 10 years.

Global Rationale: Sole ownership of a drug allows the pharmaceutical company to earn back the money spent to develop the drug. For example, if it takes 7 years for a drug to be approved, competing companies will not be allowed to market a generic equivalent drug for another 10 years. The rationale for this is that the developing company must be allowed sufficient time to recoup the millions of dollars spent in research needed to develop the new drug. After 17 years, competing companies may sell a generic equivalent drug–using a different name, which the FDA must approve. The generic version of the drug is already developed but the copyright of the drug is owned by the pharmaceutical company that developed it for 17 years. The length of time for a drug to be approved by the FDA varies. A drug can be approved in a much shorter period of time, and animal testing does not last 10 years.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-4 Distinguish between a drug’s chemical name, generic name, and trade name.

Question 10

Type: MCSA

A client asks the nurse why the healthcare provider often refers to medications by the generic name instead of by the brand name. What is the best response by the nurse?

The pharmacy will only accept a prescription written with the generic name.

The physician prefers to use a more technical-sounding name for medications.

There is only one generic name for each medication, but there are often many brand names.

The client needs to ask the physician to explain why medications have so many different names.

Correct Answer: 3

Rationale 1: Either the generic or brand name is acceptable when writing prescriptions.

Rationale 2: There is only one generic name for each medication, and using this name can prevent medication errors.

Rationale 3: There is only one generic name for each medication, but often many brand names. Using the generic name can prevent medication errors due to similar-sounding brand names of medications.

Rationale 4: There is only one generic name for each medication, and the nurse is able to explain this to the client.

Global Rationale: There is only one generic name for each medication, but often many brand names. Using the generic name can prevent medication errors due to similar-sounding brand names of medications. Either the generic or brand name is acceptable when writing prescriptions. There is only one generic name for each medication, and using this name can prevent medication errors.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-5 Explain why generic drug names are preferred to other drug names.

Question 11

Type: MCMA

Why are generic names preferred over chemical or trade names when prescribing a medication? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Chemical names are often complicated and difficult to remember.

The generic name can consistently be matched to the active ingredients.

There might be multiple trade names for a drug.

The generic name is always a shortened version of the chemical name.

Chemical names often change.

Correct Answer: 1, 2, 3

Rationale 1: Chemical names are often complicated and difficult to remember is correct because this is a reason why generic names are preferred.

Rationale 2: The generic name can consistently be matched to the active ingredients is correct because this is a reason why generic names are preferred.

Rationale 3: There might be multiple trade names for a drug is correct because this is a reason why generic names are preferred.

Rationale 4: The generic name is always a shortened version of the chemical name is incorrect because the generic name is not always a shortened version of the chemical name. For example, the chemical name of diazepam is 7-chloro-1, 3-ciphydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one.

Rationale 5: The chemical name of the drug will not change unless the composition of the drug changes.

Global Rationale: Chemical names are often complicated and difficult to remember is correct because this is a reason why generic names are preferred. The generic name can consistently be matched to the active ingredients is correct because this is a reason why generic names are preferred. There might be multiple trade names for a drug is correct because this is a reason why generic names are preferred. The generic name is always a shortened version of the chemical name is incorrect because the generic name is not always a shortened version of the chemical name. For example, the chemical name of diazepam is 7-chloro-1, 3-ciphydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one. The chemical name of the drug will not change unless the composition of the drug changes.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-5 Explain why generic drug names are preferred to other drug names.

Question 12

Type: MCSA

A nurse is talking to a client about their medications. The client tells the nurse that one of the medications on the list is on a negative formulary list and asks what this means. What is the best response by the nurse?

This means the medication can only be dispensed using the trade name medication.

This means the medication can only be dispensed using the generic medication.

This means the medication cannot be dispensed until the order is verified with the physician a second time before dispensing the trade name medication.

This means the medication can be dispensed as either the generic or trade name medication.

Correct Answer: 1

Rationale 1: A negative formulary is a list of trade name drugs that pharmacists may not dispense as generic drugs.

Rationale 2: A negative formulary is a list of trade name drugs that pharmacists may not dispense as generic drugs.

Rationale 3: A negative formulary is a list of trade name drugs that pharmacists may not dispense as generic drugs.

Rationale 4: A negative formulary is a list of trade name drugs that pharmacists may not dispense as generic drugs.

Global Rationale: A negative formulary is a list of trade name drugs that pharmacists may not dispense as generic drugs.

Cognitive Level:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-6 Discuss why drugs are sometimes placed on a restrictive list and why this is sometimes controversial.

Question 13

Type: MCSA

The nurse is teaching a client about prescribed medications. One of the medications is a controlled substance and the client asks the nurse to explain what that means. What is the best response by the nurse?

A controlled substance is regulated under the Controlled Substances Act, and may have many restrictions placed on ordering or refilling this medication.

A controlled substance requires both a written prescription and a telephone call from the prescribing practitioner.

A controlled substance does not require a prescription to purchase.

A controlled substance is always called to the pharmacy by the practitioner.

Correct Answer: 1

Rationale 1: In the United States, a controlled substance is a drug restricted by the Controlled Substances Act of 1970 and later revisions. The Controlled Substances Act is also called the Comprehensive Drug Abuse Prevention and Control Act. Hospitals and pharmacies must register with the Drug Enforcement Administration (DEA) and use their assigned registration numbers to purchase scheduled drugs. They must maintain complete records of all quantities purchased and sold.

Rationale 2: Requires both a written prescription and a telephone call from the prescribing practitioner is incorrect because Schedule II orders must be written and signed by the health care practitioner. Telephone orders to a pharmacy are not permitted. Refills for Schedule II drugs are not permitted; patients must visit their health care practitioner first.

Rationale 3: Does not require a prescription to purchase is incorrect because controlled substances require a prescription. Hospitals and pharmacies must register with the Drug Enforcement Administration (DEA) and use their assigned registration numbers to purchase scheduled drugs. They must maintain complete records of all quantities purchased and sold.

Rationale 4: A controlled substance is always called to the pharmacy by the practitioner is incorrect because Schedule II orders must be written and signed by the health care practitioner. Telephone orders to a pharmacy are not permitted. Refills for Schedule II drugs are not permitted; patients must visit their health care practitioner first.

Global Rationale: In the United States, a controlled substance is a drug restricted by the Controlled Substances Act of 1970 and later revisions. The Controlled Substances Act is also called the Comprehensive Drug Abuse Prevention and Control Act. Hospitals and pharmacies must register with the Drug Enforcement Administration (DEA) and use their assigned registration numbers to purchase scheduled drugs. They must maintain complete records of all quantities purchased and sold. Requires both a written prescription and a telephone call from the prescribing practitioner is incorrect because Schedule II orders must be written and signed by the health care practitioner. Telephone orders to a pharmacy are not permitted. Refills for Schedule II drugs are not permitted; patients must visit their health care practitioner first. Does not require a prescription to purchase is incorrect because controlled substances require a prescription. Hospitals and pharmacies must register with the Drug Enforcement Administration (DEA) and use their assigned registration numbers to purchase scheduled drugs. They must maintain complete records of all quantities purchased and sold. It is always called to the pharmacy by the practitioner is incorrect because Schedule II orders must be written and signed by the health care practitioner. Telephone orders to a pharmacy are not permitted. Refills for Schedule II drugs are not permitted; patients must visit their health care practitioner first.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-7 Explain the meaning of the term controlled substance.

Question 14

Type: MCSA

The nurse teaches a client that some drugs are frequently abused, and cause an overwhelming feeling that drives someone to use the drug repeatedly. What topic is the nurse teaching to this client?

Addiction

Psychological dependence

Physical dependence

Dependence

Correct Answer: 1

Rationale 1: Addiction refers to the overwhelming feeling that drives someone to use a drug repeatedly.

Rationale 2: Psychological dependence is incorrect because there are few signs of physical discomfort when the drug is withdrawn; however, the individual feels an intense compelling desire to continue drug use.

Rationale 3: Physical dependence refers to an altered physical condition caused by the nervous system adapting to repeated drug use. In this case, when the drug is no longer available, the individual experiences physical signs of discomfort known as withdrawal.

Rationale 4: Dependence is often defined as a physiologic or psychological need for a substance.

Global Rationale: Addiction refers to the overwhelming feeling that drives someone to use a drug repeatedly. Psychological dependence is incorrect because there are few signs of physical discomfort when the drug is withdrawn; however, the individual feels an intense compelling desire to continue drug use. Physical dependence refers to an altered physical condition caused by the nervous system adapting to repeated drug use. In this case, when the drug is no longer available, the individual experiences physical signs of discomfort known as withdrawal. Dependence is often defined as a physiologic or psychological need for a substance.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-7 Explain the meaning of the term controlled substance.

Question 15

Type: MCSA

Which drug schedule does a medication belong to if it requires a written prescription to refill?

I

IV

III

II

Correct Answer: 4

Rationale 1: Schedule I drugs are for research use only.

Rationale 2: Schedule IV drugs can be filled by written or oral prescription.

Rationale 3: Schedule III drugs can be filled by written or oral prescription.

Rationale 4: Schedule II drugs may be filled with written prescription only.

Global Rationale: Schedule II drugs may be filled with written prescription only. Schedule I drugs are for research use only. Schedule III  and Schedule IV drugs can be filled by written or oral prescription.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2-8 Explain the U.S. Controlled Substance Act of 1970 and the role of the U.S. Drug Enforcement Agency (DEA) in controlling drug abuse and misuse.

Question 16

Type: MCMA

Which of the following would be categorized as Schedule II drugs? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Morphine

Methadone

Tylenol with codeine

Valium

Heroin

Correct Answer: 1, 2

Rationale 1: Schedule II drugs carry a high potential for abuse and dependency, and include morphine and methadone.

Rationale 2: Schedule II drugs carry a high potential for abuse and dependency, and include morphine and methadone.

Rationale 3: Tylenol with codeine is incorrect because Tylenol with codeine is an example of a Schedule III drug, which carries a moderate-to-moderately-high potential for abuse and dependence.

Rationale 4: Valium is incorrect because Valium is an example of a Schedule III drug, which carries a moderate-to-moderately-high potential for abuse and dependence.

Rationale 5: Heroin is incorrect because heroin is a Schedule I drug. Schedule I drugs have the highest potential for abuse and have little or no therapeutic value.

Global Rationale: Schedule II drugs carry a high potential for abuse and dependency, and include morphine and methadone. Tylenol with codeine is incorrect because Tylenol with codeine is an example of a Schedule III drug, which carries a moderate-to-moderately-high potential for abuse and dependence. Valium is incorrect because Valium is an example of a Schedule III drug, which carries a moderate-to-moderately-high potential for abuse and dependence. Heroin is incorrect because heroin is a Schedule I drug.  Schedule I drugs have the highest potential for abuse and have little or no therapeutic value.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2-9 Identify the five drug schedules and provide examples of drugs at each level.

Question 17

Type: MCSA

What is the appropriate schedule for a drug with limited or no therapeutic use?

III

X

V

I

Correct Answer: 4

Rationale 1: Schedule III drugs have a moderate abuse potential, and are used therapeutically with prescription.

Rationale 2: Category X drugs are harmful to both women and their fetuses.

Rationale 3: Schedule V drugs are used therapeutically without prescription, and have the lowest abuse and dependency potential.

Rationale 4: Schedule I drugs have limited or no therapeutic use.

Global Rationale: Schedule I drugs have limited or no therapeutic use. Schedule III drugs have a moderate abuse potential, and are used therapeutically with prescription. Category X drugs are harmful both to women and their fetuses. Schedule V drugs are used therapeutically without prescription, and have the lowest abuse and dependency potential.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2-9 Identify the five drug schedules and provide examples of drugs at each level.

Question 18

Type: MCSA

Scheduled drugs are classified by their potential for abuse. Which classification has the highest potential for abuse?

V

II

III

I

Correct Answer: 4

Rationale 1: Schedule V drugs have the lowest abuse potential, and some of these medications are available without a prescription.

Rationale 2: Schedule II drugs have a high abuse potential, and Schedule I has the highest.

Rationale 3: Schedule III drugs have a moderate abuse potential. Schedule I has the highest abuse potential.

Rationale 4: Schedule I has the highest abuse potential.

Global Rationale: Schedule I has the highest abuse potential. Schedule II drugs have a high abuse potential. Schedule III drugs have a moderate abuse potential. Schedule V drugs have the lowest abuse potential, and some of these medications are available without a prescription.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-9 Identify the five drug schedules and provide examples of drugs at each level.

Question 19

Type: MCSA

Scheduled drugs are classified by their potential for abuse. Which classification has the lowest potential for abuse?

I

V

II

III

Correct Answer: 2

Rationale 1: Schedule I has the highest abuse potential.

Rationale 2: Schedule V drugs have the lowest abuse potential, and some of these medications are available without a prescription.

Rationale 3: Schedule II drugs have a high abuse potential, Schedule I drugs have the highest, and Schedule V drugs have the lowest.

Rationale 4: Schedule III drugs have a moderate abuse potential. Schedule I has the highest abuse potential, and Schedule V has the lowest.

Global Rationale: Schedule V drugs have the lowest abuse potential, and some of these medications are available without a prescription. Schedule I has the highest abuse potential. Schedule II drugs have a high abuse potential. Schedule III drugs have a moderate abuse potential.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-9 Identify the five drug schedules and provide examples of drugs at each level.

Question 20

Type: MCSA

A pregnant woman with a life-threatening condition must take medication that can cause harm to her fetus. What is the pregnancy category that this medication most likely represents?

A

B

C

D

Correct Answer: 4

Rationale 1: Category A carries the lowest risk to the fetus and mother.

Rationale 2: Category B drugs have not shown a risk to the fetus in animal studies, or if they have, studies of women have not confirmed this risk.

Rationale 3: Category C drugs have shown a risk in animal studies, but controlled studies have not been performed in women.

Rationale 4: Drugs from category D can cause harm to the fetus but could provide benefit to the mother in a life-threatening situation or when a safer therapy is not available.

Global Rationale: Drugs from category D can cause harm to the fetus but could provide benefit to the mother in a life-threatening situation or when a safer therapy is not available. Category A carries the lowest risk to the fetus and mother. Category B drugs have not shown a risk to the fetus in animal studies, or if they have, studies of women have not confirmed this risk. Category C drugs have shown a risk in animal studies, but controlled studies have not been performed in women.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-10 Identify the five pregnancy categories and explain what each category represents.

Question 21

Type: MCSA

Which medication would have the greatest risk to a fetus if given to a pregnant client?

Warfarin (Coumadin)

Ranitidine (Zantac)

Estrogen with progesterone (Ortho Novum)

Potassium chloride (K-Lor)

Correct Answer: 3

Rationale 1: Warfarin (Coumadin) is incorrect because it is a category D drug.

Rationale 2: Ranitidine (Zantac) is incorrect because it is a category B drug.

Rationale 3: Estrogen with progesterone (Ortho Novum) is a category X drug, and carries the highest risk; studies have shown a significant risk to women and fetuses.

Rationale 4: Potassium chloride (K-Lor) is incorrect because it is a category A drug.

Global Rationale: Estrogen with progesterone (Ortho Novum) is a category X drug, and carries the highest risk; studies have shown a significant risk to women and fetuses. Warfarin (Coumadin) is incorrect because it is a category D drug. Ranitidine (Zantac) is incorrect because it is a category B drug. Potassium chloride (K-Lor) is incorrect because it is a category A drug.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-10 Identify the five pregnancy categories and explain what each category represents.

Question 22

Type: MCSA

Which medication would have the least risk to a fetus if given to a pregnant client?

Estrogen with progesterone (Ortho Novum)

Warfarin (Coumadin)

Potassium chloride (K-Lor)

Ranitidine (Zantac)

Correct Answer: 3

Rationale 1: Estrogen with progesterone (Ortho Novum) is incorrect because it is a category X drug, and carries the highest risk; studies have shown a significant risk to women and the fetuses.

Rationale 2: Warfarin (Coumadin) is incorrect because it is a category D drug.

Rationale 3: Potassium chloride (K-Lor) is a category A drug, which has not shown risk to the fetus.

Rationale 4: Ranitidine (Zantac) is incorrect because it is a category B drug.

Global Rationale: Potassium chloride (K-Lor) is a category A drug which has not shown risk to the fetus. Estrogen with progesterone (Ortho Novum) is incorrect because it is a category X drug, and carries the highest risk; studies have shown a significant risk to women and the fetuses. Warfarin (Coumadin) is incorrect because it is a category D drug. Ranitidine (Zantac) is incorrect because it is a category B drug.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-10 Identify the five pregnancy categories and explain what each category represents.

Question 23

Type: MCSA

A pregnant client asks the nurse to explain what a teratogen is. What is the best response by the nurse to educate this client?

A teratogen is a substance that will harm a developing fetus or embryo.

A teratogen is a controlled substance.

A teratogen is a nonnarcotic pain reliever.

A teratogen is a medication used to treat bacterial infections.

Correct Answer: 1

Rationale 1: A teratogen is a medication that will harm a developing fetus or embryo.

Rationale 2: A controlled substance is regulated by the FDA, and it is possible for a drug to be a teratogen and not a controlled substance.

Rationale 3: A nonnarcotic pain reliever might or might not be a teratogen.

Rationale 4: A medication used to treat bacterial infections is an antibiotic, and might not be a teratogen.

Global Rationale: A teratogen is a medication that will harm a developing fetus or embryo. A controlled substance is regulated by the FDA, and it is possible for a drug to be a teratogen and not a controlled substance. A non-narcotic pain reliever might or might not be a teratogen. A medication used to treat bacterial infections is an antibiotic, and might not be a teratogen.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2-10 Identify the five pregnancy categories and explain what each category represents.

Holland/Adams/Brice, Core Concepts in Pharmacology, 4th edition